# Obstetric Sutures Gone Astray: A Bladder Erosion of a Cerclage Suture Leading to Recurrent Urinary Tract Infections

## TL;DR

A woman with a history of cervical cerclage developed recurring UTIs due to a suture eroding into her bladder, which was resolved after surgical removal.

## Contribution

This case report highlights suture erosion as a rare but important cause of recurrent urinary symptoms in women with prior pelvic procedures.

## Key findings

- A calcified Prolene suture from a prior cerclage was found in the bladder base and removed via cystoscopy.
- The patient's symptoms resolved completely after suture removal, with no recurrence of UTIs or hematuria.
- CT imaging was crucial in identifying the foreign body before surgical intervention.

## Abstract

Cervical cerclage is generally considered a safe procedure; however, rare complications, such as suture erosion and migration into adjacent organs, can occur. We present a case of a 31-year-old multiparous female who presented with a three-year history of recurrent urinary tract infections (UTIs), dysuria, urinary frequency, intermittent gross hematuria, and pelvic pain. She had a history of two prior cervical cerclages. Multiple courses of antibiotics failed to resolve her symptoms. CT imaging revealed a curvilinear hyperdense foreign body within the bladder. A cystoscopy was performed. Intraoperatively, a calcified Prolene suture - presumed to be a remnant from a prior cerclage - was identified at the bladder base and excised entirely. The patient had an uneventful postoperative course, with a follow-up CT confirming complete removal of the suture. The patient remained asymptomatic, with no recurrence of UTIs or hematuria on her follow-up visits.

This case highlights the importance of considering suture erosion in patients with recurrent urinary symptoms, especially in women with a history of pelvic procedures. Early recognition and definitive surgical removal can provide complete resolution of patient symptoms and optimize patient outcomes.